| NPI | 1942598883 |
|---|---|
| Doing Business As | ENCHANTED LAKE PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | TODD K. A. CLARK Co Owner/Physical Therapist 808-262-2292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2016-03-11 |